This spring, 360 sat down with CIUSSS Director of Nursing Lucie Tremblay, who joined our network at the beginning of 2019. This is the first article in a series that will be published in our staff newsletter, in which Ms. Tremblay shares her vision of the nursing profession.
360: Of all the members of the clinical team, nurses seem to be especially cautious and meticulous in the way they define their role. Why do you think that might be?
Nursing care is very regimented. We have to follow many rigorous practices to ensure our patients’ safety, seven days out of seven and 24 hours a day, so in a way it’s in our DNA. We have to be consistent in the care we provide, so that we instill confidence in our patient throughout their healthcare journey. It’s also a question of efficiency, because our interventions are crucial to sustaining our patient’s health, our patient’s life. We always need to be able to quickly find the right tools so that we can collaborate and intervene effectively.
Our challenge in the coming years will be to uphold this rigour while our practices change at an ever greater pace. I am convinced that Nursing will be compelled to evolve, because the world is changing so rapidly. When I look at the evolution of care over time, I can only imagine how dramatically it will have changed in two, three or five years’ time. If that rate of change of knowledge was quite steady in the past, it is now becoming exponential.
360: To what do you attribute that momentum?
Knowledge is being shared more rapidly. Just think of all the tools we use, whether it’s phones, tablets or computers. We find information much more quickly, but our users are also finding information faster, so the role of nurses is called upon to change.
In that respect, we will sometimes have to learn to colour outside of the pre-established lines. That won’t mean compromising on our rigour, but it will certainly mean that our roles will transform.
360: Your background is in long-term care, while now you are based in an acute-care milieu. Is this a first for you?
I taught in acute care several years ago, but I’ve spent a large part of my career caring for elderly people who were vulnerable and suffering from complex health problems. It is a patient population that we find in many of our programs. In recent years, my role at the Quebec Order of Nurses brought me a deep understanding of the contribution of nurses in all of our missions.
360: It’s still early on in your directorship, but have you had an opportunity to go up on the units?
Yes of course! I am a manager who has to maintain frequent contact with our clientele, but also with our healthcare teams.
360: And while there, have you seen directly evidence of that shift in both the savvy of the clientele, and also in the nurses having to adapt their role to new technologies that have been introduced? What have you witnessed on the ground?
I’ve had the opportunity to visit all areas of the JGH. I’ve also gone to rehabilitation sights, the long-term care facilities, as well as to the CLSCs. That doesn’t make me a specialist, but from what I’ve observed here at the hospital, we have a patient population that is increasingly heavy, with many and complex conditions. Today, people don’t come to the hospital for treatment of simple health problems, they come requiring far more serious interventions.
As to the impact of technology, I’ll give you a little example. In the past, a nurse provided pre-operative education, teaching the patient one-on-one. Today, we’ve created an entire series of videos that we give our users, they can go to a website and view short clips that explain how to prepare for their upcoming surgery.
So the nurse must have different skill sets, because that patient will watch this film before surgery and may have questions about it. They might also—because life is not linear—consult with Dr. Google, who is very, very powerful. They will often seek out further information, which means the nurse has to be prepared to respond to questions coming from many different sources, and will have to respond differently than they had merely five years ago. They will now have to help the patient separate the wheat from the chaff. There is also the whole phenomenon of technology, the vast variety of technological tools that the healthcare teams are integrating into our practice. How will these tools enable us to provide better care, without becoming impediments to care? The tool mustn’t become the object of all of our attention, we must always recall that we are in contact with a human being.
We have to be able to recognize what the tool can contribute, but also maintain that human connection, because that is also a facet of our nursing profession. Technological tools should liberate nursing staff so that they can have more time close to our users to allow them to detect and assess early signs of deterioration, and so that they can treat and support the patient throughout their care and, hopefully, a rapid recovery.